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Risk factors for diabetic retinopathy in a South Indian Type 2 diabetic population—the Chennai Urban Rural Epidemiology Study (CURES) Eye Study 4
Author(s) -
Pradeepa R.,
Anitha B.,
Mohan V.,
Ganesan A.,
Rema M.
Publication year - 2008
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2008.02423.x
Subject(s) - medicine , diabetic retinopathy , diabetes mellitus , population , type 2 diabetes , retinopathy , confidence interval , insulin , glycated hemoglobin , quartile , postprandial , epidemiology , endocrinology , environmental health
Aims To determine risk factors for diabetic retinopathy (DR) in an urban South Indian Type 2 diabetic population. Methods The Chennai Urban Rural Epidemiology Study is a large cross‐sectional study conducted in Chennai, South India. A total of 1736 Type 2 diabetic subjects were recruited for this study, which included 1382 known diabetic subjects (90.4% response rate) and 354 randomly selected, newly detected diabetic subjects diagnosed by oral glucose tolerance test. All subjects underwent four‐field stereo retinal colour photography, graded by the Early Treatment Diabetic Retinopathy Study protocol. Results Of the 1736 Type 2 diabetic subjects photographed, photographs could be graded in 1715 subjects. Stepwise ordinal logistic regression analysis revealed that male gender ( P = 0.041), duration of diabetes ( P < 0.0001), glycated haemoglobin (HbA 1c ; P < 0.0001), macroalbuminuria ( P = 0.0002) and insulin therapy ( P = 0.0001) were significantly associated with severity of DR. The risk for developing DR was 7.7 times (95% confidence interval 4.71–12.48, P < 0.0001) for elevated postprandial plasma glucose levels compared with 4.2 times (95% confidence interval 2.78–6.34, P < 0.0001) for elevated fasting plasma glucose when the fourth quartile values were compared with the first quartile glucose values. Conclusions In South Indian Type 2 diabetic subjects, duration of diabetes, HbA 1c , male gender, macroalbuminuria and insulin therapy were independent risk factors for severity of DR. Postprandial hyperglycaemia indicated a higher risk for DR compared with elevated fasting plasma glucose levels.